NHS urgent care needs integration, report says

Sir Bruce Keogh 2 - Web The NHS needs to integrate its urgent care services and simplify access to them, according to a review led by the NHS Medical Director.

Patients uncertain which service to access are “defaulting” to A&E, increasing the pressure on emergency services, the Urgent and Emergency Care Review said.

The report identified “fragmentation and diverse nomenclature” as factors reducing ease of access, and called for a more unified 24/7 system.

Sir Bruce Keogh, who led the review on behalf of NHS England, said there was an “excellent opportunity” to improve the system by simplifying access.

Demand for urgent care is growing due to the ageing population, the prevalence of long-term conditions and the proliferation of new treatments, the report noted.

The “fragmentation and variation” of acute care services in this environment is leading to over-reliance on A&E because it is easy to find at all times.

Health professionals are also unsure about the availability of urgent care services, helping to create a pattern of “patients presenting at services that may not best suit their needs”.

The report warned that many patients receiving telephone advice “lack confidence” in it and seek a second opinion, potentially duplicating services.

It recommended better patient education about the services available from community pharmacists, and called for senior clinical staff to be more available to patients (especially at weekends).

Professor Keith Willett, chair of the review’s steering group, commented: “We know that A&E is the pinch point of the health and care system and that staff are working very hard to provide the care they know the public need.

“To relieve the pressure and design a system that is sustainable and fit to meet future challenges, we need as many patients, doctors, nurses and NHS colleagues as possible to get involved.”